Instrument for inserting bead chain into urethea and bladder

ABSTRACT

A medical instrument to insert a bead chain within a patient&#39;&#39;s bladder wherein the instrument is formed into a scissors configuration with the operational ends of the scissor members including an elongated recess so as to facilitate retention of the bead chain and its location within the patient&#39;&#39;s bladder.

United States Patent [191 Nordstrom 51 Oct. 29, 1974 INSTRUMENT FORINSERTING BEAD CHAIN INTO URETHEA AND BLADDER [76] Inventor: Joel E.Nordstrom, 85 Vistalago Dr.,

Simi, Calif.

[22] Filed: Nov. 10, 1972 [21] Appl. No.: 305,292

[52] US. Cl 128/2 M, 128/303 R, 128/321, 128/346, 128/349 R [51] Int.Cl. A6lb 10/00, A6lb 17/28 [58] Field of Search 128/2 M, 2 R, 303 R,321, 128/346, 130, 343, 345, 349 R, 1.1, 1.2, 2 A,

[56] References Cited UNITED STATES PATENTS 1,973,569 9/1934 Kurtz128/321 2,109,147 2/1938 Grosso 128/321 2,397,823 4/1946 Walter 128/321FOREIGN PATENTS OR APPLICATIONS 293,929 9/1916 Germany [28/321 OTHERPUBLICATIONS Wilson, Common-Bileduct Forceps, The Lancet, Sept. 4, 1965,p. 476.

Primary Examiner-Channing L. Pace Attorney, Agent, or Firm-Robert E.Geauque [5 7] ABSTRACT A medical instrument to insert a bead chainwithin a patients bladder wherein the instrument is formed into ascissors configuration with the operational ends of the scissor membersincluding an elongated recess so as to facilitate retention of the beadchain and its location within the patients bladder.

9 Claims, 4 Drawing Figures INSTRUMENT FOR INSERTING BEAD CHAIN INTOURETI'IEA AND BLADDER BACKGROUND OF THE INVENTION The field of thisinvention relates to medical instruments and more particularly to amedical instrument particularly adapted for performing cystourethrogramsupon female human beings.

Within a human being both the urethra and the bladder are supported by amuscular sling. This sling is referred to as an arrangement of muscleslocated about both the urethra and the bladder to retain such in aparticular angular relationship with respect to each other. Thisparticular angular relationship should be approximately 90.

Women, during child birth, even normal child birth, occasionally incurinjury to the sling." The muscles and the ligaments that support thefloor of the bladder become torn. As a result, the woman is unable tocontrol her urine flow. When these muscles become torn, the anglebetween the urethra and the bladder changes from the 90 to a much largerangles such as 135 or 180.

The inability to control flow of urine as well as other symptoms whichindicate a torn sling may also be indicative of other problems. The onlyknown way to correct this problem is by surgery. Prior to the initiationof the surgery procedure, it is definitely desirable to be positive ifthe womans symptoms are a result of this torn sling." A known way inwhich the interior of ones body can be readily observed is through theuse of X-rays. However, a torn sling cannot be observed by itself froman X-ray. Therefore, a procedure known as a cystourethrogram isperformed so that the angle between the urethra and the bladder can bereadily observed by the taking of an X-ray. This cystourethrogram is tomeasure the posterior urethro vescicle angle by the inserting of a beadchain into the urethra into contact with the floor of the bladder. It isto be readily understood that the urethra is the tube from the bladderto the exterior of the body through which urine is normally passed. Thebead chain, being a high density material, and usually formed of ametallic material, is readily observed by an X-ray. Therefore, after anX-ray is taken with the bead chain installed, the angle between thebladder and the urethra can be readily measured.

If there is a slight amount of damage to the sling indicating an angleof 100 or I l, the physician may decide to postpone surgery to observethe patient for a period of time. However, normally if the angle isgreater than 120 a surgical procedure is to be performed which has beenreferred to as the Marshall- Marchetti procedure. This surgicalprocedure is to correct the muscular deficit of the sling" toreestablish the correct 90 angle between the urethra and the bladder.After the operation has been performed, a cystourethrogram is normallyagain made to insure that the proper angle has been achieved.

Previously in the performing of cystourethrograms it has been common toemploy the use of a rubber catheter as the vehicle to locate the beadchain within the urethra and the bladder. However, the use of a rubbercatheter is a tedious procedure and at times the correct placement ofthe bead chain is not established. Additionally, it is not uncommon thatin the extracting of the rubber catheter and attempting to leave thebead chain within the bladder results in the rubber catheter alsoextracting the bead chain.

SUMMARY OF THE INVENTION The medical instrument of this invention isdesigned to be specifically employed to quickly and easily deposit abead chain within the urethra and the bladder of a human being. Themedical instrument of this invention employs the use of a pair ofmembers which are connected together in a scissor-like manner with theoperational end of the instrument including elongated recesses upon themembers to facilitate the frictional grasping and retention of the beadchain therebetween. The operational end of the instrument is curved soas to facilitate the movement of the instrument through the urethra.Once the instrument has been moved to the proper position, theinstrument is manually operated to move such from the closed position toan open position which results in release of the bead chain and theplacement of such in both the urethra and the floor of the bladder. Theinstrument is then withdrawn and an X-ray taken which shows the beadchain in an angular position represented by the angle between theurethra and the bladder.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a side view of the medicalinstrument of this invention in the closed position with a bead chainbeing retained within the instrument;

FIG. 2 is a plan view of the instrument of FIG. 1;

FIG. 3 is a cross-sectional view through the handle portion of theinstrument of this invention taken along line 3-3 of FIG. 1; and

FIG. 4 is a cross-sectional view through the operational ends of theinstrument of this invention taken along line 4--4 of FIG. 2.

DETAILED DESCRIPTION OF THE SHOWN EMBODIMENT Referring particularly tothe drawings, there is shown in FIG. 1 the medical instrument 10 of thisinvention which basically comprises a first elongated member 12 and asecond elongated member 14. The first elongated member 12 is formed intoan operating end 16 and an operational end 18. The second elongatedmember 14 is also formed into an operating end 20 and an operational end22. It is to be noted that, as shown in FIG. 2 of the drawing, theoverall instrument 10 is bowed or curved which is caused by theconstructing of the members Hand 14 in a cooperating curved manner.

A pin 24 connects together the members 12 and 14 intermediate therepsective ends in a pivoting relationship. As a result. therelationship between the members 12 and 14 substantially resembles ascissors.

The operating end 16 includes an enlarged element 26 which includes anenlarged opening 28. The operating end 20 also includes an enlargedelement 30 with an enlarged opening 32 formed therein. The function ofthe openings 28 and 32 is to facilitate location of a persons finger ofthumb therein. This permits the members 12 and 14 to be pivotally movedabout the pin 24 in a manner similar to a conventional scissors.

Connected to the enlarged member 26 is a protuberance 34. Connected tothe enlarged member 30 is a catch 36. With the instrument 10 of thisinvention in a closed position, the catch 36 cooperates with the protuisformed into an elongated recess 38. The surface of the operational end22 which faces the recess 38 is similarly formed into an elongatedrecess 40. A bead chain 42 is to be locatable between the operationalends 18 and 22 of the instrument 10 of this invention with the roundbeads of the bead chain 42 cooperating within the recesses 38 and 40.This cooperating recess configuration tends to retain the bead chainwithin the instrument l and prevent accidental dislodgment therefrom.

In order to insert the bead chain 42 within the bladder of a humanbeing, ther person desiring to insert such locates the bead chain 42within the instrument as shown in FIG. ll of the drawings. With the beadchain 42 so installed, the person closes the instrument 10 resulting incatch 36 cooperating with protuberance 34 and latching the instrumentIt) in the closed position. In this position the bead chain 42 istightly grasped in a frictional manner between the operational ends 18and 22.

The person then inserts the operational ends 18 and 22 of the instrument10 into the urethra of the patient and continues to insert such to asufficient depth so that the bead chain 42 will come into contact withthe floor of the bladder. The person then positions the instrument 10 sothat upon opening thereof, the bead chain ill readily fall by gravityand become disassociated from the instrument. With the person havingopened the instrument 10 while it is located in the desired positionwithin the urethra and the bladder, the person then extracts theinstrument 10 from the patient. Normally the length of the bead chain 42is selected so that a portion thereof extends exteriorly of the patientsbody. This permits for each extraction after taking of the X-ray. Withthe bead chain so installed, an X-ray is to be taken which will resultin a clear showing of the angle between the bladder nd the urethra.

I claim:

1. A medical instrument to insert a bead chain into a patients bladdercomprising:

a first elongated member having an operating end and an operational end;

a second elongated member having an operational end and an operationalend;

connecting means to pivotally connect together said first and saidsecond members intermediate said ends; each of said operating endsincluding first means for facilitating manual pivoting of said membersabout a pivot axis with respect to each other; and

each of said operational ends includes second means for facilitating theretention of a bead chain, said second means comprises a longitudinalrecess formed within both said members, such both said recessesextending substantially the entire length of its respective operationalend, each said recess being a uniform depth and width along said entirelength of its respective operational end, each of said operational endsbeing curved so as to result in a smooth contour to facilitate locatingof said medical instrument within the urethra, said pivot axis lyingwithin the plane of said curve.

2. A medical instrument as defined in claim 1 wherein:

said operational ends capable of assuming a substantially alignedabutting relationship with respect to each other with there being asurface upon one of said operational ends capable of coming intosubstantial abutting contact with a surface upon the other of saidoperational ends.

3. A medical instrument as defined in claim 1 includa latching meansconnected to said members, said latching means to retain said members ina closed position.

4. The medical instrument as defined in claim 3 wherein:

said latching means located on said operating ends.

5. In combination with a bead chain, said bead chain to be inserted intoa patients bladder to perform a cystourethrogram, a medical instrumentto insert said bead chain comprising:

a first elongated member having an operating end and an operational end;

a second elongated member having an operating end and an operationalend;

connecting means to pivotally connect together said first and secondmembers intermediate said end;

' each of said operating ends including first means for facilitatingmanual pivoting of said members with respect of each other; and

each of said operational ends includes second means for facilitating theretention of said bead chain.

6. The combination of claim 5 wherein:

said operational ends capable of assuming a substantially alignedabutting relationship with respect to each other with there being asurface upon one of said operational ends capable of coming intosubstantial abutting contact with a surface upon the other of saidoperational ends, said second means includes forming of an elongatedrecess along one of said surfaces of a said operational end.

7. The combination as defined in claim 6 wherein:

both of said surfaces of said operational ends are formed into anelongated recess, whereby the bead chain is readily adapted to betemporarily retained within each of said elongated recesses with saidmembers in a closed position.

8. The combination as defined in claim 6 wherein:

each of said operational ends is curved whereby to facilitate locatingof said medical instrument within the urethra.

9. The combination as defined in claim 8 wherein:

a latching means it is connected to said members, said latching adaptedto retain said members in a closed position.

l l a

1. A medical instrument to insert a bead chain into a patient''s bladdercomprising: a first elongated member having an operating end and anoperational end; a second elongated member having an operational end andan operational end; connecting means to pivotally connect together saidfirst and said second members intermediate said ends; each of saidoperating ends including first means for facilitating manual pivoting ofsaid members about a pivot axis with respect to each other; and each ofsaid operational ends includes second means for facilitating theretention of a bead chain, said second means comprises a longitudinalrecess formed within both said members, such both said recessesextending substantially the entire length of its respective operationalend, each said recess being a uniform depth and width along said entirelength of its respective operational end, each of said operational endsbeing curved so as to result in a smooth contour to facilitate locatingof said medical instrument within the urethra, said pivot axis lyingwithin the plane of said curve.
 2. A medical instrument as defined inclaim 1 wherein: said operational ends capable of assuming asubstantially aligned abutting relationship with respect to each otherwith there being a surface upon one of said operational ends capable ofcoming into substantial abutting contact with a surface upon the otherof said operational ends.
 3. A medical instrument as defined in claim 1including: a latching means connected to said members, said latchingmeans to retain said members in a closed position.
 4. The medicalinstrument as defined in claim 3 wherein: said latching means located onsaid operating ends.
 5. In combination with a bead chain, said beadchain to be inserted into a patient''s bladder to perform acystourethrogram, a medical instrument to insert said bead chaincomprising: a first elongated member having an operating end and anoperational end; a second elongated member having an operating end andan operational end; connecting means to pivotally connect together saidfirst and seconD members intermediate said end; each of said operatingends including first means for facilitating manual pivoting of saidmembers with respect of each other; and each of said operational endsincludes second means for facilitating the retention of said bead chain.6. The combination of claim 5 wherein: said operational ends capable ofassuming a substantially aligned abutting relationship with respect toeach other with there being a surface upon one of said operational endscapable of coming into substantial abutting contact with a surface uponthe other of said operational ends, said second means includes formingof an elongated recess along one of said surfaces of a said operationalend.
 7. The combination as defined in claim 6 wherein: both of saidsurfaces of said operational ends are formed into an elongated recess,whereby the bead chain is readily adapted to be temporarily retainedwithin each of said elongated recesses with said members in a closedposition.
 8. The combination as defined in claim 6 wherein: each of saidoperational ends is curved whereby to facilitate locating of saidmedical instrument within the urethra.
 9. The combination as defined inclaim 8 wherein: a latching means it is connected to said members, saidlatching adapted to retain said members in a closed position.